A Tale of Two Cancers

Experiencing first breast cancer and then pancreatic cancer

She and I have known each other since she was treated for breast cancer in 2002. It was a Stage III cancer, and she was appropriately anxious about her future. She endured surgery, radiation and very tough chemotherapy. After the treatment was concluded, it took a long time for her to regain her baseline level of energy and strength. It took even longer to begin to believe that the cancer might not recur, and that she might stay well. Over the years, I was in intermittent contact with her and celebrated her good health.

Luck was with her until she was diagnosed with pancreatic cancer in the fall of 2017. No one ever expects to get cancer, but this was a particular shock. Given her history of breast cancer, she assumed that she had, so far, outlived her cancer problems. She has done extremely well both physically and psychologically with this diagnosis and treatment that included chemotherapy, radiation and Whipple surgery.

She spoke candidly about her two experiences and this is my summary of our discussion. She calls her story, "Not My First Rodeo."

A lot of the difference between the two experiences was related to how much better she felt during the pancreatic cancer chemotherapy than she had years before with breast cancer treatment. Remembering those months, she was very worried about embarking on another round of chemo, but this one turned out to be much easier. This time, she had the benefit of the newer anti-nausea and white blood cell drugs that weren’t available when she was treated for breast cancer. That first time, she was very sick and was even hospitalized once. She remembers spending most of her time in the bathroom or lying on the couch. This time, despite the intensity of pancreatic cancer chemo, she was able continue going to the gym, traveling and caring for her mother who was dying. This was a big, and much appreciated, surprise.

She notes that she had the “advantage” of already having been through chemo, so the idea of treatment wasn’t scary. None of the chemo paraphernalia was frightening, and she didn’t need a friend to accompany her to chemo. She was treated at the same institution and even had the same chemo nurse. Everything about having chemo and being an active cancer patient was familiar.

What she found more interesting was the response of other people when she told them of her diagnosis with pancreatic cancer. People were upset this time while they had been reassuring when the diagnosis was breast cancer. Everyone knows someone who has had breast cancer and is fine now. This is often not so with pancreatic cancer. She selectively shared the news of this diagnosis, and part of her discretion was not wanting to have to cope with the reactions of other people.

This time, the chemo did not make her hair fall out, and she continued to feel reasonably well. It was possible to keep the diagnosis and treatment secret in much of her life. There were, of course, some very dear family members and friends who knew and were wonderfully loving and supportive. It turned out to be helpful to have spaces in life where no one knew what she was going through, so hours or days could seem more normal.

For breast cancer, there are lots of support groups, publicity, stories of hope and all of Pink October. November is Pancreatic Cancer month, but you don’t see purple packaging on the grocery shelves or NFL players wearing purple sneakers. It is almost impossible to avoid exposure to breast cancer in October, but pancreatic cancer barely ripples the surface of November.

The big difference is the only one that counts: survival. She had a Stage III breast cancer and is still here 16 years later. Her pancreatic cancer was Stage I, but the statistics are still grim. The chances of surviving more than three years are uncertain. Fortunately, she was treated with new chemo combinations and very aggressive surgery, approaches that were not used until recently. We are hopeful that the long term statistics for people treated this way will be much better. New developments in research and clinical care give patients authentic reasons for hope. In BIDMC's Pancreatic Cancer Program, an internationally known center of pancreatic cancer care and research, patients are treated by an experienced multidisciplinary team. They receive the very best medical, surgical, and psychosocial care that is available.

I know a number of people who were treated for pancreatic cancer many years ago, without the benefit of new chemotherapy combinations and more sophisticated surgery, and are doing well. I hope that my friend has the same experience.